Fenger Pointing

Becky Fenger | August 19, 2009

Whether you call it health care reform, government takeover of health care, socialized medicine or health insurance reform – President Barack Obama's term – we'd better be very, very skeptical when we hear news stories of its likely demise. Beasts don't die easily.

For my money, the best analysis of the behemoth bill (HR 3200) is that of health policy expert Betsey McCaughey, PhD. You can find it by going to www.defendyourhealthcare.us. The bright lady has made it simple for us by giving page numbers for her assertions, along with little arrows.

In clear and concise language, Dr. McCaughey describes how we Americans will be forced to give up our health care insurance plans and enroll in a government-designed "qualified" plan, whether privately insured or through our employers, sooner or later. And we must be darned certain we can prove it by stapling a copy of the plan to our income tax returns! If a sorry soul can't prove it, he or she will be fined thousands of dollars. Employers may be given up to five years to switch over, but you know how time flies when you're having fun.

The tricky part of the deal is that we do not know specifics on what is covered and how much it will cost us. We will find out those niceties some eighteen months after Congress approves a bill. What is known is that the government will be the one dictating what the terms are, while Obama keeps telling us it is all about choice. As McCaughey explains: "We are told we must have apples for dinner, but we get to pick the apple." Some choice! Far from voluntary, our health care plan will be clearly mandatory.

I'm sick of watching older Americans being made fun of for having great concerns. At a Town Hall meeting in New Hampshire, President Obama conceded that his legislation will be paid for not just with tax hikes but also a $500 billion cut to Medicare over the next ten years (10 percent of its budget) at the same time that 30 percent more people will be enrolling in Medicare. As McCaughey points out, this will mean rationing of the very procedures that have transformed the experience of aging for seniors.

The fact that the Drudge Report showed a white flag flying earlier this week with the headline: "Team Obama Drops Public Option" should not be seen as a retreat, as touted by some. Obama needs to get something – anything – passed, whatever form it takes. "Once it's in place, health care 'reform' can be re-reformed endlessly," columnist Mark Steyn warns us.

Obama and his Health and Human Secretary, Kathleen Sebelius, both claim that the public option is "not essential to the plan." On that, McCaughey agrees. But she strongly urges us to resist the requirement that the government gets to set the standards. That's the nub of the problem.

There are better ways to cover the uninsured. McCaughey says this could be done in an immediate way for about a third of the current price of Obama's plan. For instance, all 50 states use debit card technology to deliver food purchasing power to low income families. The General Accounting Office claims this new method has virtually eliminated the fraud, waste and abuse in the food stamp program.

"Why not employ the same administrative setup to deliver purchasing power for people who need to buy health coverage," she asks. Why not offer a high deductible plan for low and middle income families? (The poor are already covered by Medicaid, although 14 million of them have not bothered to sign up.) She estimates this could be done for between $28 billion to $35 billion or up to $49 billion for a more comprehensive plan for them. That's pocket change compared to what's being discussed in Congress' plan.

It's interesting to note that the Federal Council for Comparative Effectiveness Research, which is the real rationing body for health care, was embedded in the Stimulus Bill and not in the current plans. The cost of a procedure is divided by the number of quality-adjusted life years the patient is going to benefit. "Older people have a denominator problem," McCaughey laments. I should say!

Space prevents me from pointing out all the plans put forth by Republican members of Congress, e.g., that of U.S. Rep. John Shadegg, but they're there. Obama has convinced folks that it's his plan or no plan. Thank God that's not true.